How many charts must a collaborating physician review for a North Carolina NP?

In North Carolina, a collaborating physician is not required to review a specific number of NP charts. Instead of a fixed chart-review quota, the rules require an ongoing quality review process and scheduled supervision meetings¹²³, as well as physician review of certain orders within a reasonable time and periodic review of drugs prescribed⁴⁵.

What is required instead of a set chart count?

• Ongoing review of care with a written quality improvement plan for frequently encountered problems at each practice site¹.
• Monthly meetings during the first six months of a new collaborative practice to discuss clinical issues and quality measures, with signed and dated documentation retained for five years².
• A quality improvement process meeting at least every six months thereafter, with documentation retained for five years³.
• For orders in facilities, provision for physician review of the NP’s orders within a reasonable time after ordering, as determined by the Medical Board⁴.
• For prescribing, a written policy for periodic physician review of the drugs prescribed by the NP⁵.

Because supervision is individualized, practices should tailor their review processes to the NP’s setting, experience, and scope, consistent with the collaborative practice agreement; the Medical Board emphasizes that the appropriate amount of supervision depends on multiple factors⁶.